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coronary microvascular dysfunction

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https://www.readbyqxmd.com/read/28429698/coronary-microvascular-dysfunction-equivalent-to-left-main-coronary-artery-disease
#1
Cafer Panç, Mehmet Kocaağa, Onur Erdoğan, Remzi Sarıkaya, Sabahattin Umman
Coronary microvascular dysfunction, also known as cardiac syndrome X, is a clinical syndrome presenting with typical angina and evidence of myocardial ischemia in the absence of flow-limiting stenosis on coronary angiography. Of patients undergoing coronary angiography due to suspected myocardial ischemia, 50% are found to have normal or near-normal coronary arteries. Described in this case report is a patient who developed hypotension and ST segment depressions during treadmill exercise test. Left main coronary artery or multivessel disease was suspected...
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28429664/alternative-causes-of-myocardial-ischemia-in-women-an-update-on-spontaneous-coronary-artery-dissection-vasospastic-angina-and-coronary-microvascular-dysfunction
#2
Bina Ahmed, Mark A Creager
Although coronary obstruction due to atherosclerosis is the most common cause of myocardial ischemia, a significant proportion of patients have myocardial ischemia in the absence of obstructive epicardial coronary artery disease (CAD). This finding is more common among women and alternative causes can mediate myocardial ischemia. Abnormalities in vascular structure, alterations in coronary vasomotion and dysfunction of the coronary microcirculation can all cause ischemia in the absence of obstructive CAD due to atherosclerosis...
April 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28420647/incremental-value-of-transthoracic-doppler-echocardiography-assessed-coronary-flow-reserve-in-patients-with-suspected-myocardial-ischemia-undergoing-myocardial-perfusion-scintigraphy
#3
Li-Ming Gan, Sara Svedlund, Ann Wittfeldt, Charlotte Eklund, Sinsia Gao, Göran Matejka, Anders Jeppsson, Per Albertsson, Elmir Omerovic, Amir Lerman
BACKGROUND: Adenosine-assisted transthoracic Doppler-derived coronary flow reserve (TDE-CFR) reflects coronary vascular function. The prognostic and incremental value of left anterior descending coronary artery TDE-CFR above myocardial perfusion scintigraphy in patients with suspected myocardial ischemia has not yet been studied. METHODS AND RESULTS: Three hundred seventy-one patients (mean age, 62.3±8.7 years; 46.8% males) referred to myocardial perfusion scintigraphy attributed to suspected myocardial ischemia were included in the study...
April 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28415836/diabetic-cardiomyopathy-where-we-are-and-where-we-are-going
#4
Wang-Soo Lee, Jaetaek Kim
The global burden of diabetes mellitus and its related complications are currently increasing. Diabetes mellitus affects the heart through various mechanisms including microvascular impairment, metabolic disturbance, subcellular component abnormalities, cardiac autonomic dysfunction, and a maladaptive immune response. Eventually, diabetes mellitus can cause functional and structural changes in the myocardium without coronary artery disease, a disorder known as diabetic cardiomyopathy (DCM). There are many diagnostic tools and management options for DCM, although it is difficult to detect its development and effectively prevent its progression...
April 18, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28410144/cardiotoxicity-in-oncology-and-coronary-microcirculation-future-challenges-in-theranostics
#5
Giovanni Peretto, Davide Lazzeroni, Carmem L Sartorio, Paolo G Camici
Many of the patients undergoing chemotherapy or radiotherapy for cancer are at increased risk of developing cardiovascular diseases. Recent evidence suggests that cardiac dysfunction and subsequent heart failure are mainly due to vascular toxicity rather than only to due to myocyte toxicity. However, not all of the vascular toxicity of cancer therapies can be explained by epicardial coronary artery disease. In fact, in the last decades, it has been found that myocardial ischemia may occur as a consequence of structural or functional dysfunction of the complex network of vessels, which cannot be seen by a coronary angiography: the coronary microcirculation...
June 1, 2017: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/28409033/aborted-sudden-cardiac-death-in-a-female-patient-presenting-with-takotsubo-like-cardiomyopathy-due-to-epicardial-coronary-vasospasm
#6
Sorin Giusca, Tom Eisele, Peter Nunninger, Benedikt Münz, Grigorios Korosoglou
Takotsubo cardiomyopathy is characterized by apical ballooning of the left ventricle (LV) in the absence of relevant coronary artery stenosis, which typically occurs in elderly women after emotional stress. Catecholamine cardiotoxicity, metabolic disturbance, and coronary microvascular impairment have previously been proposed as underlying pathophysiologic mechanisms of takotsubo cardiomyopathy, whereas myocardial stunning resulting from epicardial coronary artery vasospasm is not generally accepted as a cause of takotsubo cardiomyopathy...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28374328/epicardial-and-microvascular-coronary-vasomotor-dysfunction-and-its-relation-to-myocardial-ischemic-burden-in-patients-with-non-obstructive-coronary-artery-disease
#7
Edoardo Verna, Sergio Ghiringhelli, Stefano Provasoli, Simone Scotti, Jorge Salerno-Uriarte
AIM: To assess the relative contribution of epicardial endothelium-dependent (EDD) and microvascular endothelium-independent (EIMVD) coronary vasomotor dysfunction to the extent of myocardial ischemia in patients with normal angiograms or non-obstructive coronary artery disease (NOCAD). METHODS: Coronary vasomotion was evaluated by quantitative angiography and blood flow (CBF) measurements during intracoronary acetylcholine, nitroglycerine, and adenosine in 101 patients...
April 3, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28341374/cardiorenal-disease-connection-during-post-menopause-the-protective-role-of-estrogen-in-uremic-toxins-induced-microvascular-dysfunction
#8
REVIEW
Jiayi Pei, Magdalena Harakalova, Hester den Ruijter, Gerard Pasterkamp, Dirk J Duncker, Marianne C Verhaar, Folkert W Asselbergs, Caroline Cheng
Female gender, post-menopause, chronic kidney disease (CKD) and (CKD linked) microvascular disease are important risk factors for developing heart failure with preserved ejection fraction (HFpEF). Enhancing our understanding of the interrelation between these risk factors could greatly benefit the identification of new drug targets for future therapy. This review discusses the evidence for the protective role of estradiol (E2) in CKD-associated microvascular disease and related HFpEF. Elevated circulating levels of uremic toxins (UTs) during CKD may act in synergy with hormonal changes during post-menopause and could lead to coronary microvascular endothelial dysfunction in HFpEF...
March 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28295341/exercise-training-reverses-age-induced-diastolic-dysfunction-and-restores-coronary-microvascular-function
#9
Kazuki Hotta, Bei Chen, Bradley J Behnke, Payal Ghosh, John N Stabley, Jeremy A Bramy, Jaime L Sepulveda, Michael D Delp, Judy M Muller-Delp
The risk for diastolic dysfunction increases with advancing age. Regular exercise training ameliorates age-related diastolic dysfunction; however, the underlying mechanisms have not been identified. We investigated whether 1) microvascular dysfunction contributes to the development of age-related diastolic dysfunction, and 2) initiation of late-life exercise training reverses age-related diastolic and microvascular dysfunction. Young and old rats underwent 10 weeks of exercise training or remained as sedentary, cage-controls...
March 10, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28289007/ischemia-and-no-obstructive-coronary-artery-disease-inoca-developing-evidence-based-therapies-and-research-agenda-for-the-next-decade
#10
REVIEW
C Noel Bairey Merz, Carl J Pepine, Mary Norine Walsh, Jerome L Fleg
The Cardiovascular Disease in Women Committee of the American College of Cardiology, in conjunction with interested parties (from the National Heart, Lung, and Blood Institute, American Heart Association, and European Society of Cardiology), convened a working group to develop a consensus on the syndrome of myocardial ischemia with no obstructive coronary arteries. In general, these patients have elevated risk for a cardiovascular event (including acute coronary syndrome, heart failure hospitalization, stroke, and repeat cardiovascular procedures) compared with reference subjects and appear to be at higher risk for development of heart failure with preserved ejection fraction...
March 14, 2017: Circulation
https://www.readbyqxmd.com/read/28266999/combination-of-panaxadiol-and-panaxatriol-type-saponins-and-ophioponins-from-shenmai-formula-attenuates-lipopolysaccharide-induced-inflammatory-injury-in-cardiac-microvascular-endothelial-cells-by-blocking-nf-kappa-b-pathway
#11
Jinqiang Zhu, Yubin Liang, Shaoqian Yue, Guanwei Fan, Han Zhang, Meng Zhang
Vascular inflammatory injury leads to vascular endothelial dysfunction, thereby resulting in a variety of cardiovascular diseases (CVDs). Thus, attenuating vascular inflammatory injury has great significance for the prevention and treatment of CVDs. In China, Shenmai formula, a well-known ancient Chinese prescription, has been widely used to treat CVDs, such as coronary atherosclerosis and viral myocarditis. In vivo study has demonstrated that the optimal combination of 3 major active components from Shenmai formula, panaxadiol and panaxatriol type saponins and ophioponins, in a ratio of 1:2:2 might exert significant cardioprotective effects and anti-inflammatory activities...
March 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28219921/predictive-value-of-dobutamine-stress-perfusion-echocardiography-in-contemporary-end-stage-liver-disease
#12
Bipul Baibhav, Chetaj A Mahabir, Feng Xie, Valerie K Shostrom, Timothy M McCashland, Thomas R Porter
BACKGROUND: The assessment of cardiac risk in contemporary liver transplantation (LT) has required more sensitive testing for the detection of occult coronary artery disease as well as microvascular and functional cardiac abnormalities. Because dobutamine stress perfusion echocardiography provides an assessment of both regional systolic and diastolic function as well as microvascular perfusion (MVP), we sought to examine its incremental value in this setting. METHODS AND RESULTS: We evaluated the predictive value of dobutamine stress perfusion echocardiography in 296 adult patients with end-stage liver disease and preserved systolic function who underwent LT between 2008 and 2014...
February 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28218606/microvascular-dysfunction-following-st-elevation-myocardial-infarction-and-its-recovery-over-time-is-associated-with-short-and-long-term-cardiac-function
#13
Mariëlla E C J Hassell, Matthijs Bax, Martijn A van Lavieren, Robin Nijveldt, Alexander Hirsch, Lourens Robbers, Koen M Marques, Jan G P Tijssen, Felix Zijlstra, Albert C van Rossum, Ronak Delewi, Jan J Piek
AIMS: It is unclear whether microvascular dysfunction following ST-elevation myocardial infarction (STEMI) is prognostic for long-term left ventricular function (LVF). and whether recovery of the microvasculature status is associated with LVF improvement. METHODS AND RESULTS: In 62 patients, Coronary Flow Reserve (CFR) and Hyperemic Microvascular Resistance Index (HMRI) in the infarct related artery (IRA) was assessed by intracoronary Doppler flow measurements within 1 week and at 4 months...
February 21, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28207868/acetylcholine-versus-cold-pressor-testing-for-evaluation-of-coronary-endothelial-function
#14
Ahmed AlBadri, Janet Wei, Puja K Mehta, Sofy Landes, John W Petersen, R David Anderson, Bruce Samuels, Babak Azarbal, Eileen M Handberg, Quanlin Li, Margo Minissian, Chrisandra Shufelt, Carl J Pepine, C Noel Bairey Merz
BACKGROUND: Assessment of coronary endothelial function with intracoronary acetylcholine (IC-Ach) provides diagnostic and prognostic data in patients with suspected coronary microvascular dysfunction (CMD), but is often not feasible due in part to the time and expertise needed for pharmacologic mixing. Cold pressor testing (CPT) is a simple and safe stimulus useful for either invasive or non-invasive endothelial function testing and myocardial perfusion imaging but has not been specifically evaluated among symptomatic women with signs of ischemic heart disease (IHD) who have no obstructive coronary artery disease (CAD)...
2017: PloS One
https://www.readbyqxmd.com/read/28203465/st-segment-elevation-myocardial-infarction-and-normal-coronary-arteries-after-consuming-energy-drinks
#15
S Michael Gharacholou, Nkechinyere Ijioma, Emma Banwart, Freddy Del Carpio Munoz
The use of energy drinks, which often contain stimulants, is common among young persons, yet there have been few reports of adverse cardiac events. We report the case of a 27-year-old man who was admitted to our facility with an acute ST-segment elevation myocardial infarction in the setting of using energy drinks. Angiography revealed no obstructive coronary disease. The patient had elevation of cardiac troponin. Noninvasive testing with echocardiography and cardiac magnetic resonance imaging demonstrated both abnormalities in resting wall motion at the anterior apex along with late gadolinium enhancement of the anterior wall, respectively...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28131704/notch3-deficiency-impairs-coronary-microvascular-maturation-and-reduces-cardiac-recovery-after-myocardial-ischemia
#16
Yong-Kang Tao, Heng Zeng, Guo-Qiang Zhang, Sean T Chen, Xue-Jiao Xie, Xiaochen He, Shuo Wang, Hongyan Wen, Jian-Xiong Chen
RATIONALE: Vascular maturation plays an important role in wound repair post-myocardial infarction (MI). The Notch3 is critical for pericyte recruitment and vascular maturation during embryonic development. OBJECTIVE: This study is to test whether Notch3 deficiency impairs vascular maturation and blunts cardiac functional recovery post-MI. APPROACH AND RESULTS: Wild type (WT) and Notch3 knockout (Notch3KO) mice were subjected to MI by the ligation of left anterior descending coronary artery (LAD)...
January 24, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28130064/cardiovascular-consequences-of-metabolic-syndrome
#17
REVIEW
Johnathan D Tune, Adam G Goodwill, Daniel J Sassoon, Kieren J Mather
The metabolic syndrome (MetS) is defined as the concurrence of obesity-associated cardiovascular risk factors including abdominal obesity, impaired glucose tolerance, hypertriglyceridemia, decreased HDL cholesterol, and/or hypertension. Earlier conceptualizations of the MetS focused on insulin resistance as a core feature, and it is clearly coincident with the above list of features. Each component of the MetS is an independent risk factor for cardiovascular disease and the combination of these risk factors elevates rates and severity of cardiovascular disease, related to a spectrum of cardiovascular conditions including microvascular dysfunction, coronary atherosclerosis and calcification, cardiac dysfunction, myocardial infarction, and heart failure...
May 2017: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/28094311/evidence-of-microvascular-changes-in-the-retina-following-kawasaki-disease
#18
Katherine Y H Chen, David P Burgner, Tien Y Wong, Seang Mei Saw, Swee Chye Quek, Audrey Y C Pang, Seo Wei Leo, Inez B Wong, Diana Zannino, Nigel Curtis, Michael Cheung, Carol Y Cheung, Terence C W Lim
It is unclear whether all children with Kawasaki disease (KD) have increased later cardiovascular risk. The retinal microvasculature reflects changes in the microcirculation and is associated with traditional cardiovascular risk factors and events. The aim of this study was to investigate retinal microvascular parameters in two populations of patients with previous KD and control participants. We performed case-control studies of 116 (57 patients and 59 control participants) Australian and 156 (78 patients and 78 control participants) Singaporean individuals, at least two years since their acute illness...
January 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28089194/left-ventricular-global-longitudinal-strain-predicts-major-adverse-cardiac-events-and-all-cause-mortality-in-heart-transplant-patients
#19
Tor Skibsted Clemmensen, Hans Eiskjær, Brian Bridal Løgstrup, Lars Bo Ilkjær, Steen Hvitfeldt Poulsen
BACKGROUND: Left ventricular global longitudinal strain (LVGLS) is a robust longitudinal myocardial deformation marker that is strongly affected by cardiac allograft vasculopathy (CAV), microvascular dysfunction, and acute cellular rejection (ACR). We evaluated graft deformation for risk stratification in long-term heart transplant (HTx) patients. METHODS: The study included 196 patients who underwent HTx between 2011 and 2013. Patients underwent comprehensive echocardiography and coronary angiography...
December 15, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28081214/cold-pressor-stress-cardiac-magnetic-resonance-myocardial-flow-reserve-is-not-useful-for-detection-of-coronary-endothelial-dysfunction-in-women-with-signs-and-symptoms-of-ischemia-and-no-obstructive-cad
#20
Sofy Landes, Sherwin Dela Cruz, Janet Wei, Ahmed AlBadri, Chrisandra Shufelt, Puja Mehta, Louise E Thomson, Marcio A Diniz, Xiao Zhang, John W Petersen, R David Anderson, Carl J Pepine, Daniel S Berman, C Noel Bairey Merz
BACKGROUND: Coronary endothelial function testing using acetylcholine is not routinely available, while non-pharmacological cold pressor testing (CPT) is considered an endothelial stressor. Noninvasive cardiac magnetic resonance imaging (CMRI) myocardial perfusion reserve index (MPRI) can detect coronary microvascular dysfunction (CMD). We evaluated if CPT stress CMRI MPRI could detect invasive coronary endothelial dysfunction. METHODS: Coronary reactivity testing was performed in 189 women with symptoms and signs of ischemic but no obstructive coronary artery disease as previously described plus CPT stress...
2017: PloS One
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